Cheng Liu, Donghui Pan, Yuyun Sun, Xiaoping Xu, Zhongyi Yang, Min Yang, Shaoli Song
{"title":"ER和HER2双示踪PET成像在转移性乳腺癌患者中的作用：一项初步研究","authors":"Cheng Liu, Donghui Pan, Yuyun Sun, Xiaoping Xu, Zhongyi Yang, Min Yang, Shaoli Song","doi":"10.1007/s12149-025-02071-2","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Accurate and real-time evaluation of tumor ER and HER2 status is essential for improving the clinical management of patients with metastatic breast cancer (MBC). The purpose of this pilot study was to investigate the value of PET imaging with <sup>18</sup>F-FES and <sup>68</sup> Ga-HER2 affibody for the noninvasive evaluation of the ER and HER2 status in MBC patients. </p><h3>Methods</h3><p>From January 2021 to September 2023, 17 metastatic breast cancer (MBC) patients underwent <sup>1</sup>⁸F-FES and ⁶⁸Ga-HER2-affibody PET/CT within one month, with concurrent <sup>1</sup>⁸F-FDG PET/CT for tumor glycolytic activity evaluation. The imaging data were integrated to detect lesions and analyze intra-patient heterogeneity. The efficacy of lesion detection across different modalities was evaluated, along with an assessment of their potential impact on clinical decision-making. </p><h3>Results</h3><p>A total of 174 metastatic lesions were detected: 163 (93.7%) showed high <sup>1</sup>⁸F-FDG uptake, 91 (52.3%) exhibited <sup>1</sup>⁸F-FES positivity, and 104 (59.8%) demonstrated ⁶⁸Ga-HER2-affibody binding. The biopsy correlation revealed significantly higher <sup>1</sup>⁸F-FES and ⁶⁸Ga-HER2-affibody uptake in ER-positive (<i>P</i> < 0.05) and HER2-positive (<i>P</i> < 0.05) lesions, respectively, compared to their negative counterparts. In clinical decision-making influenced by PET findings, 12 of 17 patients (70.6%) had treatment strategies concordant with <sup>1</sup>⁸F-FES and ⁶⁸Ga-HER2-affibody PET results. Among nine dual-positive patients (both tracers positive), 55.6% (5/9) were administered combined endocrine therapy and anti-HER2 targeted regimens, thereby obviating chemotherapy. In single-tracer-positive subgroups, 100% (2/2) of <sup>1</sup>⁸F-FES + /⁶⁸Ga-HER2 − cases received endocrine therapy (with or without CDK4/6 inhibitors), whereas 66.7% (2/3) of ⁶⁸Ga-HER2 + /<sup>1</sup>⁸F-FES − patients were treated with anti-HER2 therapy (with or without chemotherapy). Notably, three dual-negative patients were not prescribed antihormonal or anti-HER2 agents; instead, they received chemotherapy (with or without immunotherapy), avoiding inappropriate targeted interventions.</p><h3>Conclusion</h3><p>Dual-tracer PET imaging enables noninvasive assessment of ER/HER2 status and intratumoral heterogeneity, providing critical insights for personalized treatment strategies in MBC.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1113 - 1123"},"PeriodicalIF":2.5000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The role of dual-tracer PET imaging with ER and HER2 in patients with metastatic breast cancer: a pilot study\",\"authors\":\"Cheng Liu, Donghui Pan, Yuyun Sun, Xiaoping Xu, Zhongyi Yang, Min Yang, Shaoli Song\",\"doi\":\"10.1007/s12149-025-02071-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Accurate and real-time evaluation of tumor ER and HER2 status is essential for improving the clinical management of patients with metastatic breast cancer (MBC). The purpose of this pilot study was to investigate the value of PET imaging with <sup>18</sup>F-FES and <sup>68</sup> Ga-HER2 affibody for the noninvasive evaluation of the ER and HER2 status in MBC patients. </p><h3>Methods</h3><p>From January 2021 to September 2023, 17 metastatic breast cancer (MBC) patients underwent <sup>1</sup>⁸F-FES and ⁶⁸Ga-HER2-affibody PET/CT within one month, with concurrent <sup>1</sup>⁸F-FDG PET/CT for tumor glycolytic activity evaluation. The imaging data were integrated to detect lesions and analyze intra-patient heterogeneity. The efficacy of lesion detection across different modalities was evaluated, along with an assessment of their potential impact on clinical decision-making. </p><h3>Results</h3><p>A total of 174 metastatic lesions were detected: 163 (93.7%) showed high <sup>1</sup>⁸F-FDG uptake, 91 (52.3%) exhibited <sup>1</sup>⁸F-FES positivity, and 104 (59.8%) demonstrated ⁶⁸Ga-HER2-affibody binding. The biopsy correlation revealed significantly higher <sup>1</sup>⁸F-FES and ⁶⁸Ga-HER2-affibody uptake in ER-positive (<i>P</i> < 0.05) and HER2-positive (<i>P</i> < 0.05) lesions, respectively, compared to their negative counterparts. In clinical decision-making influenced by PET findings, 12 of 17 patients (70.6%) had treatment strategies concordant with <sup>1</sup>⁸F-FES and ⁶⁸Ga-HER2-affibody PET results. Among nine dual-positive patients (both tracers positive), 55.6% (5/9) were administered combined endocrine therapy and anti-HER2 targeted regimens, thereby obviating chemotherapy. In single-tracer-positive subgroups, 100% (2/2) of <sup>1</sup>⁸F-FES + /⁶⁸Ga-HER2 − cases received endocrine therapy (with or without CDK4/6 inhibitors), whereas 66.7% (2/3) of ⁶⁸Ga-HER2 + /<sup>1</sup>⁸F-FES − patients were treated with anti-HER2 therapy (with or without chemotherapy). Notably, three dual-negative patients were not prescribed antihormonal or anti-HER2 agents; instead, they received chemotherapy (with or without immunotherapy), avoiding inappropriate targeted interventions.</p><h3>Conclusion</h3><p>Dual-tracer PET imaging enables noninvasive assessment of ER/HER2 status and intratumoral heterogeneity, providing critical insights for personalized treatment strategies in MBC.</p></div>\",\"PeriodicalId\":8007,\"journal\":{\"name\":\"Annals of Nuclear Medicine\",\"volume\":\"39 10\",\"pages\":\"1113 - 1123\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-06-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s12149-025-02071-2\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s12149-025-02071-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The role of dual-tracer PET imaging with ER and HER2 in patients with metastatic breast cancer: a pilot study
Objective
Accurate and real-time evaluation of tumor ER and HER2 status is essential for improving the clinical management of patients with metastatic breast cancer (MBC). The purpose of this pilot study was to investigate the value of PET imaging with 18F-FES and 68 Ga-HER2 affibody for the noninvasive evaluation of the ER and HER2 status in MBC patients.
Methods
From January 2021 to September 2023, 17 metastatic breast cancer (MBC) patients underwent 1⁸F-FES and ⁶⁸Ga-HER2-affibody PET/CT within one month, with concurrent 1⁸F-FDG PET/CT for tumor glycolytic activity evaluation. The imaging data were integrated to detect lesions and analyze intra-patient heterogeneity. The efficacy of lesion detection across different modalities was evaluated, along with an assessment of their potential impact on clinical decision-making.
Results
A total of 174 metastatic lesions were detected: 163 (93.7%) showed high 1⁸F-FDG uptake, 91 (52.3%) exhibited 1⁸F-FES positivity, and 104 (59.8%) demonstrated ⁶⁸Ga-HER2-affibody binding. The biopsy correlation revealed significantly higher 1⁸F-FES and ⁶⁸Ga-HER2-affibody uptake in ER-positive (P < 0.05) and HER2-positive (P < 0.05) lesions, respectively, compared to their negative counterparts. In clinical decision-making influenced by PET findings, 12 of 17 patients (70.6%) had treatment strategies concordant with 1⁸F-FES and ⁶⁸Ga-HER2-affibody PET results. Among nine dual-positive patients (both tracers positive), 55.6% (5/9) were administered combined endocrine therapy and anti-HER2 targeted regimens, thereby obviating chemotherapy. In single-tracer-positive subgroups, 100% (2/2) of 1⁸F-FES + /⁶⁸Ga-HER2 − cases received endocrine therapy (with or without CDK4/6 inhibitors), whereas 66.7% (2/3) of ⁶⁸Ga-HER2 + /1⁸F-FES − patients were treated with anti-HER2 therapy (with or without chemotherapy). Notably, three dual-negative patients were not prescribed antihormonal or anti-HER2 agents; instead, they received chemotherapy (with or without immunotherapy), avoiding inappropriate targeted interventions.
Conclusion
Dual-tracer PET imaging enables noninvasive assessment of ER/HER2 status and intratumoral heterogeneity, providing critical insights for personalized treatment strategies in MBC.
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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